Introduction: Acute myocardial infraction typically associated with atherosclerosis and coronary lesions, can occur without significant stenosis, implicating microcirculatory obstruction. Case Presentation: We present a case of a 60-year-old woman with hypertension and atrial fibrillation who was admitted with chest pain. Initially diagnosis of high-risk NSTEMI, but coronary angiography showed no significant lesions. Cardiac MRI revealed myocardial necrosis, indicating myocardial infraction with non-obstructive coronary arteries (MINOCA). Further investigation identified polycythemia vera as the cause. The patient was transferred to the hematology department and discharged with DAPT, atorvastatin, and bisoprolol. Conclusion: The case presented illustrates the importance of recognizing polycythemia vera as an important cause of thrombosis, not only of MI with significant coronary lesion, but also of MI with non-obstructive coronary arteries.
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Haless et al. (2024) studied this question.
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